Cocaine long term effects

A review of cocaine’s long term effects to the body, brain, and behavior.

minute read

The word most often used to describe cocaine’s initial “rush”, which courses through the body and brain of the user is euphoria. It’s this euphoria which compels people (for good reason!) to use coke again and again. The rush of dopamine is what makes cocaine a highly addictive substance, primarily based on the intense pleasure that floods the brain and senses of the user, from the very first hit.

So, what are the long term effects of using cocaine? How does it influence your body, brain and behavior and what are the symptoms of cocaine addiction? We examine here. Then, we invite your questions about the long terms effects of cocaine use at the end. In fact, we try to answer all questions personally and promptly.

Long term effects of cocaine use on behavior

One of the first long term effects of cocaine is needing to use more cocaine over time. When users continue to cocaine over time, it becomes necessary to increase doses to achieve the same initial effect. This is known as “tolerance to cocaine“. Chronic use of cocaine in high doses can produce the effects of tolerance within about one (1) week of frequent use.

Then, regular or heavy use of cocaine begins to show in the behavior of the user, in terms of behavior. Heavy use of cocaine is defined as the use of two (2) or more grams a weeks, at least four (4) times a month for one year. For these types of long term users, symptoms can manifest such as:

  • agitation
  • argumentative or aggressive behavior
  • insomnia
  • irritation
  • jittery body movement
  • rapid speech patterns or
  • weight loss due to lack of appetite

Some users begin to have delusions or hallucinations and may become psychotic, violent and paranoid. But what some other effects of cocaine on the body and its systems?

Long term effects of cocaine on the body

Cocaine affects the body over the long term in a variety of ways. It constricts blood vessels, dilates pupils, and increases body temperature, heart rate, and blood pressure. It can also cause headaches and gastrointestinal complications such as abdominal pain and nausea.

Because cocaine tends to decrease appetite, chronic users can become malnourished as well. Most seriously, people who use cocaine can suffer heart attacks or strokes, which may cause sudden death. Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by an arrest of breathing.

Long term effects of cocaine on the brain

Repeated exposure to cocaine changes the brain. The brain starts to adapt to its presence, and the reward pathways of neurotransmitters becomes less sensitive to natural reinforces and to the drug itself. As discussed earlier, tolerance may develop, which means that higher doses and/or more frequent use of cocaine is needed to register the same level of pleasure experienced during initial use.

At the same time, users can also become more sensitive (sensitization) to cocaine’s anxiety-producing, convulsant, and other toxic effects. What’s more is that mental deficits can develop as a result of reduced blood flow to the brain. Some people who quit using cocaine have trouble paying attention or remembering conversations; others can be disruptive in groups by being disinhibited with constant interruptions, beginning tasks without waiting for all the instructions, and may become aggressive.

Long term effects of cocaine on a fetus

Effects of cocaine on pregnancy are not yet conclusive. As there have been no long-term studies into the effect of prenatal cocaine in humans, evidence for cocaine-induced cardiac programming is lacking in humans.

Despite the lack of direct evidence of long-term human programming, studies in humans clearly show that prenatal cocaine exposure results in alterations to the heart and the autonomic nervous system. These findings (and long-term effects seen in animal models) strongly suggest that fetal cocaine exposure is capable of inducing cardiac programming and is likely a significant risk factor for morbidity and mortality secondary to myocardial ischemia in adulthood.

Long term effects of cocaine abuse

After a long time of using cocaine, there are serious symptoms that are going to appear. These can include:

  • addiction
  • anxiety, panic attacks, and paranoia
  • difficulty sleeping
  • gastrointestinal problems
  • increased risk of viral and bacterial infection (including STDs)
  • mood disturbance
  • nasal damage and difficulty swallowing
  • restlessness

Long term effects of cocaine addiction

The effects of addiction to cocaine are numerous and many changes can happen to you, both physically and mentally. Once someone become addicted to cocaine, quitting without relapse become extremely difficult, even after long periods of abstinence. This difficulty is caused by functional and structural changes to the brain, affecting neurotransmission and sensitivity to the chemical dopamine. Basically, you begin to feel very depressed and experience intense cravings for coke.

Depression can become a part of your everyday life, and when you stop using coke, these symptoms can last for months following cessation of long-term heavy use (particularly daily). Symptoms may also be associated with suicidal thoughts in some people.

After a long time of using, you’ll also experience powerful, intense cravings for cocaine. However, the “high” associated with ongoing use becomes less and less pleasant, and can produce fear and extreme suspicion rather than joy (euphoria). Just the same, the cravings may remain powerful.

Can cocaine long term effects damage you permanently?

We’re not quite sure.

Episodes of hyper-manic sexual behaviors and other manic pursuits of pleasurable activity can start after you quit using cocaine, such as overeating or addictive types of pleasure seeking. These activities seem to try to compensate for the dulling of certain systems in the brain.

Physical effects on the brain are numerous. Permanent damage to the brain may include imbalance in neurotransmitter function in the prefrontal cortex and the midbrain. These parts of the brain are responsible for pleasurable experiences.

Pleasure sensations may become difficult for the long-term or chronic user to experience. They may not experience pleasure in things they once enjoyed. Why? Brain images show a decreased number of dopamine receptors in the brain of a person addicted to cocaine versus a non drug user. The dopamine system is important for conditioning and motivation. Still, neuroscientists are amazed as the resilience of the brain…and long term users can repair or restore brain function in the months and years after use.

What about long term effects on the body?

Regularly snorting cocaine can lead to loss of sense of smell and an overall irritation of the nasal septum, even damage by causing permanent holes in the soft tissue. Imagine a chronically inflamed, runny nose with a hole between the nostrils.

Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. And those who inject cocaine have puncture marks called “tracks,” most commonly in their forearms, and may experience allergic reactions, which in severe cases can result in death. Plus, significant weight loss and malnourishment are the result of regular cocaine use, the result of which can cause permanent damage to internal organs.

Are you using cocaine long term?

Have you been stuck in a rut of using and quitting coke, and then using again? We invite your questions or comments in the section below. We want to hear from you and help if we can! If we can’t answer your questions, we’ll refer you to someone who can.

Reference Sources: NIDA Notes: Cocaine abuse may lead to strokes and mental deficits
NIH: What are the long-term effects of cocaine use?; Cocaine; Health Effects
NIDA: Drug Facts on Cocaine
NIDA: Health effects of commonly abused drug
MedlinePlus: Cocaine withdrawal
NCBI: Short and long-term adverse effects of cocaine abuse during pregnancy on the heart development
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.


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  1. Ive done cocaine for 8 months straight everyday more and more. All of a sudden these last few weeks im feeling sick. The smell is over bearing and the taste is making me sick. I dont know why my body is rejecting the coke! Any ideas?

    1. Hi Jessica. Maybe the cocaine you were taking was cut with something that makes you sick. Or maybe it is just your body not being able to handle the cocaine. Have you considered getting clean? Cocaine can have devastating effects on your body and mind. Help is available.Call us to discuss treatment options.

  2. Right. Im 28 n Av been doin coke in rediculas amounts for the last 8 years. For example. This week i had my first line ov beek on the tuesday night and find myself still sat hear, the following saterday night, on my own, having continuasly kept buyin more in the amount ov 5 grams at a time, spending an total of 900 pounds without any sleep and no food…if i by sum miricle manage 2 kick this horrable yet glorious drug.. would the damage i have inflicted on myself be a serious problem in later life??? That is if i make it to a later life at al !!

    1. Hi Tom. Long term use of cocaine can leave serious consequences on someone’s health. Also, I suggest you talk with a doctor so they can run some tests. It is never too late to seek treatment that will address all the underlining causes of addiction and help you built new healthier habits. Please feel free to call our helpline.

  3. I’m using cocaine full time since August last year almost every day until December last year, I had about one month away from it which was January this year but since then I’m using one to 3 grams a week don’t want to be using but can’t get away from it and I’ve such a tolerance from it nobody is aware I’m using it

    1. Hi Eamon. Cocaine is hard to quit. I suggest that you call the helpline to talk with a trusted treatment consultant who can help you find the best rehab for you.

  4. Hi, I’ve been using cocaine for 3 years now. 2 years very heavy. I found out today I am pregnant. I have done at least a gram everyday before today. Will my baby be healthy?

  5. Well, my story is pretty much like Jill’s and I hate it, I could own a house right now. But my problems are so much easier because of the situation I’m in, I don’t have to work or anything… Basically, I’m lucky with a life of drugs, cars, shopping and friends and this is something I no longer want, at least the drugs part. And my main concern is I’m about to have some major testing done because of a much different situation so far I’ve been clean about a week, it’s really not that hard for me because I’ve been doing it for about 10 yrs straight and I’m on and off a lot. What I really need to know is, how long does it stay in your blood, I’m having some blood test in about 3 weeks and it is going to pull up everything and if it shows I’m gonna be cut off “money wise” really quick and then I’ll have nothing. So since I’ve been clean a week now and I have another 3 weeks to go, will my blood rid of it? Besides that after just this one week, I’ve been really using that money to pay bills and treat myself with something other that is a total waste and the people that were getting that money really do not deserve it at all. I mean, they have horrible attitudes and I’ve only put up with it because I new I’d be calling them in a few more hours, so then I just started getting enough to last the day, but I’d still be calling the next. I personally like not talking to them and just doing my own thing w/o that in my life. So it won’t be hard for me, but please tell me how long for a very heavy user have traces in the blood. Will it show after almost a month of being clean?
    Oh, I totally missed another big question I have also. You see, I’m also on prescription medications that are kinda in high demand, but do need them and that’s part of the whole reason for these test being done. But I do share some of them with friends, so another question is will it show if what I’m given, the amount in my blood, or could I just take like a few extra days before and on the day of testing, take a little more also? Or should I just keep them all to myself since I just had them filled, so it would show that amount in my system? All of this is so confusing I really hope you’re able to understand what I’m saying and answer me somewhat to the best of your knowledge….. Thanks kindly for taking your time to read and answer my questions.

  6. I am a binge user. I go out sometimes all night, or, it may be a few dollars and the thought pops into mind and I’m off. Afterwards I feel completely useless to anybody especially my children. I have shamed myself to my Lord. Its like this spontaneous choice, this push that is a thorn in my side. The only way to stop the shame is to ask for forgiveness. The people around me deserve to here it too. Unfortunately lately I have been using regularly, and I have been living with a man I fell in love with 4 years ago. He is very ill now, and I being 35, and him 59, I find myself replacing boredom with using. I am very sorry for what I’ve done to him including all the worrying, the lies, and the wasted money. Why am I having such a hard time stopping this time. I’m gonna end up back in jail my children need one sain parent, and I believe I can take care of my love. I’m so tired of using, but is that tonight. God help me

    1. Hi Tara. I suggest you call the number displayed on the website to get in touch with our trusted treatment consultants to speak about your treatment options.

  7. I honestly don’t even know where to begin. I began snorting cocaine here and there in college, but when I graduated I got into the “city party scene”, where it was always easily accessible. Binges would sometimes last from Friday night to Saturday afternoon at some random persons apartment for “after hours”. Three nights a week of this shit was utter maddness. Then cocaine eventually became something I would take home with me… Something I felt like I couldn’t live without. It just made me so happy while using it and a was able to function… I guess you could call me a functioning addict, until my life eventually became completely unmanageable. I was always able to hold down my professional career, but definitely started struggling to keep up at work when all I was thinking about was getting my next high. To make a long story short, I wound up with a 4 year cocaine addiction, a perforated septum, $100,000’s of thousands of saved, hard earned money GONE before the blink of an eye. A “normal” day consisted in buying $200 of cocaine, but it got so bad at one point that I got up to using $400 a day… All up my nose. I feel disgusted and ashamed and ANGRY at myself for allowing this to happen to me. I have been to Rehab, MICA programs, and most recently, a dual diagnosis outpatient program. BUT NOTHING SEEMS TO WORK!!! This drug is so powerful that it has taken over my entire life. I honestly don’t even know how to live without it anymore. And I know if I keep this up I am going to wind up dead from a heart attack or something, causing my family even more grief that they should not have to endure. Someone out there who can relate to my story PLEASE HELP ME… I feel like rock bottom is right around the corner. I need serious help to battle this disease known as addiction.

    1. Hi, Jill. You need to stay strong, and fight with all your strength to overcome addiction. Believe in yourself, and you’ll do it! I suggest you call the helpline on our site to get in touch with our trusted treatment providers who can help you make the best decision for you.

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